August 16th, 2011 by Happy Hospitalist in Opinion, Research
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Association of Hospitalist Care With Medical Utilization After Discharge: Evidence of Cost Shift From a Cohort Study.
That’s the title of the latest medical study making the viral rounds. I had an opportunity to read the study in full. I called Happy’s hospital library and Judy had the pdf article in my email in less than 24 hours. Now, that’s amazing. Thanks Judy for a job well done. You deserve a raise.
Presented in the August 2nd, 2011 edition of the journal Annals of Internal Medicine, Volume 155 Number 3 Page 152-159, the study concludes that decreased length of stay and hospital costs associated with hospitalist care are offset by higher medical utilization and costs after discharge.
In summary, hosptitalist patients had an adjusted length of stay 0.64 days shorter and $282 less than patients cared for by primary care physicians, but total 30 day post discharge costs were $332 higher. These additional charges were defined as 59% from rehospitalization, 19% from skilled-nursing facilities, and 22% from professional and other services.
OK fair enough. Let’s come to that conclusion. Let’s say Read more »
*This blog post was originally published at The Happy Hospitalist*
August 15th, 2011 by Lucy Hornstein, M.D. in Opinion
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Seven months into 2011, things look very different than they did this time last year at my office. Not only have I been using an electronic medical record for nine months now, but I’ve also been submitting claims electronically (through a free clearinghouse) using an online practice management system. I’ve also begun scanning patients’ insurance cards into the computer, as well as converting all the paper insurance Explanation of Benefits (EOBs) into digital form. I’ve even scanned all my office bills and business paperwork and tossed all the actual paper into one big box. As of the first of the year I even stopped generating “daysheets” at the end of work each day. After all, with my new system I can always call up the information I want whenever I need it.
How did such a committed papyrophile get to this point? It is the culmination of a process that actually began last summer with the purchase of an adorable refurbished little desktop scanner from Woot ($79.99, retails for $199, such a deal!) The organizational software is useless for my purposes, but it does generate OCR PDFs, which makes copying and pasting ID numbers from insurance cards into wherever else they need to be a piece of proverbial cake. The first step was to start Read more »
*This blog post was originally published at Musings of a Dinosaur*
August 15th, 2011 by Glenn Laffel, M.D., Ph.D. in Health Policy, Opinion
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In recent weeks, several Democrats and some health reform advocates including the AMA have joined Republicans in calling for a repeal of provisions in the new health law that create the Independent Payment Advisory Board (IPAB). For these people, IPAB represents the worst aspects of the new law–an unelected, centralized planning authority empowered by government to make decisions about the peoples’ health care. Arbitrary cuts to providers, short-sighted decisions that stifle innovation and rationing of care are sure to follow, they claim.
While it’s true that the rules governing IPAB are flawed and should be fixed, eliminating IPAB altogether would be a mistake. Read more »
*This blog post was originally published at Pizaazz*
August 9th, 2011 by Stanley Feld, M.D. in Health Policy, Opinion
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I have discussed Medicare Part B and Part F in recent blogs. A reader asked about Medicare Part D:
Dr. Feld
“Please discuss Medicare Part D, the drug benefit plan available to seniors. It is very complicated and completely confusing to me.
My physician gave me a prescription for Levequin 500 mg once a day for 10 days. The pharmacist told me it would cost me $330 dollars. Medicare Part D would pay an additional $110 dollars for a total of $440 dollars.
I asked the pharmacist if there was a generic equivalent. The answer was yes. It cost $10 dollars.
This is unconscionable. It is highway robbery.
Sincerely
a.g.”
Several issues are presented in this readers note. It is essential to understand these issues. The issues are an indictment against government “controlled” programs. Read more »
*This blog post was originally published at Repairing the Healthcare System*
August 7th, 2011 by Happy Hospitalist in Opinion, Research
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I’ve been telling my smoking patients for years that nothing I do for them is going to make an ounce of difference until they quit smoking for good. And the Italians are out to prove me right. The American Journal of Cardiology reported July 11th, 2011 on the Effect of Smoking Relapse On Outcome After Acute Coronary Syndrome.
In a study of just under 1,300 patients, Reuters reports that just over 1/2 the patients started smoking within 20 days of hospital discharge, despite in-hospital smoking cessation consultation for all patients. Researchers also found that resuming smoking increased death 3-fold compared with those that did not relapse and quitting smoking had a similar lifesaving effect as taking cholesterol and blood pressure medications. And I’m sure these folks all landed themselves back into the hospitals for a very expensive dying process.
That’s why billing the patient or their insurance for smoking cessation (CPT® 99406 and 99407) is so important. And that’s why I give many of my smoking patients my smoking lecture. You know how much Medicare pays for a ten minute consultation to help cardiac patients quit smoking right now? Read more »
*This blog post was originally published at The Happy Hospitalist*
